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Doctors Renew Warning on Asthma Drugs

Salmeterol, when combined with corticosteroid, can pose problems for some people

WEDNESDAY, Aug. 23, 2006 (HealthDay News) -- Asthma experts at the University of Iowa have added their voices to growing warnings about medications, such as Advair, that use the long-acting asthma drug salmeterol in combination with an inhaled corticosteroid.

In some patients, this combination can make asthma more severe or even fatal, the experts write in a letter published in the Aug. 24 issue of the New England Journal of Medicine.

The letter describes two such cases handled by the University of Iowa doctors. Both patients had life-threatening problems related to salmeterol use. When they switched to a different asthma medication, their asthma was brought under control.

"For most patients whose asthma cannot be controlled with a low-dose inhaled steroid, adding salmeterol to the steroid provides increased benefits. So there's no question this can be a useful combination drug for many individuals," Dr. Miles Weinberger, professor of pediatrics, said in a prepared statement.

"However, some patients are receiving the combination drug but don't actually need it, and there is at least a small subgroup of patients for whom previous research showed the salmeterol-steroid combination has a very negative, rather than beneficial effect," he said.

The drug Advair contains salmeterol in addition to an inhaled steroid. Advair, which is one the most commonly prescribed asthma medications in the United States, is meant to be used on a regular, preventive basis. It's not designed to treat sudden asthma attacks, Weinberger noted.

"We do not want to unduly alarm people, but instead help spread the word that patients should talk to their physicians if they are using Advair, or another inhaled asthma medication that contains salmeterol and feel that it worsens symptoms instead of making them better," he said.

A U.S. study released earlier this year found that the risk of asthma-related death over 7 months in patients who took salmeterol was 13 in 13,000 people, compared to three in 13,000 in patients who took a placebo.

More information

The U.S. National Heart, Lung, and Blood Institute has more about asthma.

SOURCE: University of Iowa, news release, Aug. 23, 2006
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